Data-Medicos 
Dermagic/Express No. 3-(98) 
31 Marzo 2.001 31 March 2.001. 


EDITORIAL ESPANOL 
================= 
Hola amigos DERMAGIC de nuevo con ustedes, el tema de hoy LA LINFANGITIS ESCLEROSANTE DEL PENE. Esta patologia realmente es POCO CONOCIDA, por muchos y por ello la presento hoy. De hecho no encontre FOTOS en la internet sobre ella. En mi busqueda por la red encontre 2 casos descritos asociados a cuadros POST herpes genital, uno a Clamydia, Y OTRO a sifilis, donde proponen los autores descartar siempre esta enfermedad (SIFILIS) en esta condicion. TODAS estas son enfermedades de transmision sexual, entonces hay que pensar que existe una variante VENEREA Y OTRA NO VENEREA ASOCIADA A TRAUMATISMO LOCAL (masturbacion y relaciones sexuales). OTROS autores la relacionan a antigenos relacionados con el factor VIII de la coagulacion y proponen el termino de FLEBITIS DE MONDOR DEL PENE. 
El tratamiento todo un reto para cualquier dermatologo, por lo general la enfermedad desaparece en varias semanas y se recomienda evitar relaciones sexuales y masturbacion para evitar el trauma local, uno o quiza el principal factor que la ocasiona.

GRACIAS al Dr. Rolando Hermandez (VENEZUELA) por las Fotos. 

En las referencias los hechos. 

Saludos a todos... 

Dr Jose Lapenta R. 

EDITORIAL ENGLISH
================= 
Hello friends DERMAGIC again with you, the today topic SCLEROSING LYMPHANGITIS OF THE PENIS. This pathology is really NOT VERY WELL-KNOWN, for many and for I present it today. In fact I didn't find PICTURES in the internet on her. In my search for the net I found 2 described cases associated to POST herpes genitalis, one to Chlamydia, AND ANOTHER to syphilis, where the authors intend to always discard this illness (SYPHILIS) in this condition. ALL these they are illnesses of sexual transmission, then it is necessary to think that a VENEREAL AND NON-VENEREAL variants exists. The non-venereal variant probably ASSOCIATED TO LOCAL TRAUMATISM (masturbation and sexual relationships). OTHER authors relate it to antigens related with the factor VIII of the clotting and they propose the I TERM of MONDOR'S phlebitis OF THE PENIS. 
The treatment an entire challenge for any dermatologist, in general the illness disappears in several weeks and it is recommended to avoid sexual relationships and masturbation to avoid the local trauma, maybe the main factor that causes it. 

Thanks to Dr. Rolando Hernandez (VENEZUELA) for the pictures.

In the references the facts. 

Greetings to all... 

Dr José Lapenta R. 

============================================================ 
REFERENCIAS BIBLIOGRAFICAS / BIBLIOGRAPHICAL REFERENCES 
============================================================ 
0.) SCLEROSING LYMPHANGITIS OF THE PENIS. THE HISTORY
1.) Non-venereal sclerosing lymphangitis of the penis following herpes progenitalis. 
2.) Nonvenereal sclerosing lymphangitis of the penis. 
3.) [Sclerosing lymphangitis of the penis, the upper lip and the labium minus] 
4.) Nonvenereal sclerosing lymphangitis of the penis. 
5.) Non-venereal sclerosing lymphangitis of the penis. 
6.) Non-venereal sclerosing lymphangitis of the penis. A clinicopathologic treatise. 
7.) Mondor's phlebitis of the penis. A condition miscalled 'non-venereal sclerosing lymphangitis'. 
8.) Circular indurated lymphangitis of the penis. 
9.) [Indications for corticotherapy in phlebology] 
10.) [A case for diagnosis: sclerosing lymphangitis of the penis]. 
11.) [Non-venereal sclerosing lymphangitis of the penis]. 
12.) [Non-venereal sclerosing lymphangitis of the penis]. 
13.) Nonvenereal sclerosing lymphangitis of the penis. 
14.) [A case of non-venereal sclerosing lymphangitis of the penis]. 
15.) [A case of Mondor's disease of the penis]. 
16.) Non-venereal sclerosing lymphangitis of the penis associated with masturbation. 
17.) [2 cases of sclerosing lymphangitis of the sex organs]. 
18.) Mondor's phlebitis of the penis: a study with factor VIII related antigen. 
19.) [Non-venereal sclerosing lymphangitis of the penis revealed as phlebitis by positive factor
VIII-related antigen]. 
20.) Surgical management of persistent, symptomatic nonvenereal sclerosing lymphangitis of the penis. 
21.) Sclerosing lymphangitis of the penis: a lymphangiofibrosis thrombotica occlusiva. 
22.) Sclerosing lymphangitis of the penis: a possible chlamydia aetiology. 
23.) [Development of non-venereal sclerosing lymphangitis of the penis following herpetic balanitis]. 
24.) [Case of sclerosing lymphangitis of the sex organs]. 
25.) [Nonveneral sclerosing lymphangitis of the penis]. 
26.) Benign transient lymphangiectasis (sclerosing lymphangitis) of the penis. 
27.) [Sclerosing lymphagitis of the penis]. 
28.) Lymphocoele and localized lymphoedema of the penis. 
29.) Nonvenereal sclerosing lymphangitis of the penis. 
30.) Sclerosing non-venereal lymphangitis of the penis]. 
31.) Sclerosing lymphangitis of the penis. 
32.) Nonvenereal sclerosing lymphangitis of the penis. 
============================================================ 
0.) SCLEROSING LYMPHANGITIS OF THE PENIS. THE HISTORY
============================================================ 
SOURCE: MED HELP INTERNATIONAL
Forum: The Urology Forum 
Question Posted By: Jonathan on Thursday, December 30, 1999


I have a condition that in many respects appears to be sclerosing lymphangitis - a vein-like fibrous area under the skin, just below or medial from the glans, on the left side of the penis, going around the circumference. The left end can move or when I touch it, but on the right end seems to be connected internally. When I am not erect, it is about 1/2 inch long and 1/16 inch wide. When I am erect or it is irritated, it is 3/4 inch long and 1/8 inch wide. When I am having sex, it can fairly easily become painful and/or swollen. 

I first encountered it about 10 years ago, after a period of intense masturbation. The problem is that it has not gone away, though I have had periods of a month or more with no sexual activity or masturbation. In the last year, it has gotten worse in that it is longer, more prominent during sexual activity, and more often painful. Often I feel a soreness or itchiness (under the skin surface) after sexual activity. Using a condom tends to increase the symptoms.

Recently, I have seen a couple of dermatologists about this, one of whom suggested that it may be sclerosing lymphangitis. I then went to two urologists, neither of whom was familiar with the term. All have said that there is no STD or other such problem is present. 

So my question is - are there non-surgical ways of helping this heal? And if it persists, how do I find urologists who have treated this problem?

Thank you.


Answer Posted By: HFHS M.D.-BL on Thursday, December 30, 1999

Dear Jonathan,

Sclerosing lymphangitis is a translucent cordlike lesion that occurs on the shaft of glans of the penis. It is usually flesh-colored but may appear slightly red. It is most commonly associated with vigorous sexual activity, but it is also seen with infections including gonorrhea, syphilis, chlamydia, and herpes. When biopsy specimens are looked at under the microscope, thrombosed lymphatic vessels are seen. The thrombosis of these vessels is theorized to be secondary to the local trauma.


Most cases of Sclerosing Lymphangitis of the penis are not painful and remit within several weeks. Treatment has traditionally consisted of avoidance of vigorous sexual activity until the lesion disappears. I am not sure how long you initially went without sex once you were given a preliminary diagnosis, but you may have started sexual activity too soon. Unfortunately a true diagnosis of Sclerosing Lymphangitis would necessitate a biopsy and examination under a microscope, but this is rarely required. This disorder is usually self-limited (lasting only a few weeks), but in a few rare cases in which there are persistent symptomatic lesions surgery is indicated. For a rare and confusing case such as yours I would suggest that you seek a urologist at an academic hospital with a Urology residency training program. 


This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).

============================================================ 
1.) Non-venereal sclerosing lymphangitis of the penis following herpes progenitalis. 
============================================================ 
SO - Br J Dermatol 1977 Jun;96(6):679-80 
AU - Van de Staak WJ 
PT - JOURNAL ARTICLE 
AB - Two patients are described in which non-venereal sclerosing lymphangitis of the penis
occurred immediately after a herpes simplex infection. The possibility of a causal relationship
between these two conditions is discussed. 

============================================================ 
2.) Nonvenereal sclerosing lymphangitis of the penis. 
============================================================ 
SO - Arch Dermatol 1975 Jul;111(7):902-3 
AU - Fiumara NJ 
PT - JOURNAL ARTICLE 
AB - Sclerosing lymphangitis of the penis with a purplish, cord-like structure, singular or multiple
around the coronal sulcus, appears 24 to 48 hours after sexual relations. There is edema of the glans
penis and coronal area, which is doughy and plastic. The condition is self-limited. 

============================================================ 
3.) [Sclerosing lymphangitis of the penis, the upper lip and the labium minus] 
============================================================ 
SO - Hautarzt 1974 May;25(5):231-7 
AU - Stolz E; Kampen WJ van; Vuzevski V 
PT - JOURNAL ARTICLE 

============================================================ 
4.) Nonvenereal sclerosing lymphangitis of the penis. 
============================================================ 
SO - Arch Dermatol 1972 May;105(5):728-9 
AU - Greenberg RD; Perry TL 
PT - JOURNAL ARTICLE 

============================================================ 
5.) Non-venereal sclerosing lymphangitis of the penis. 
============================================================ 
SO - Br J Dermatol 1970 Jun;82(6):632-3 
AU - Boyd AS 
PT - JOURNAL ARTICLE 

============================================================ 
6.) Non-venereal sclerosing lymphangitis of the penis. A clinicopathologic treatise. 
============================================================ 
SO - Acta Derm Venereol 1970;50(4):309-12 
AU - Kandil E; al-Kashlan IM 
PT - JOURNAL ARTICLE 

============================================================ 
7.) Mondor's phlebitis of the penis. A condition miscalled 'non-venereal sclerosing lymphangitis'. 
============================================================ 
SO - Clin Exp Dermatol 1977 Mar;2(1):65-7 
AU - Findlay GH; Whiting DA 
PT - JOURNAL ARTICLE 

============================================================ 
8.) Circular indurated lymphangitis of the penis. 
============================================================ 
SO - Arch Dermatol 1976 Aug;112(8):1146 
AU - Baden HP; Provan J; Tanenbaum L 
PT - JOURNAL ARTICLE 
AB - Circular lymphangitis of the penis has been seen in three of our patients, two of whom
complained of mild discomfort. A patient with syphilis was initially misdiagnosed because of similar
clinical findings. A serologic test for syphilis should be performed in all patients with this disorder. 

============================================================ 
9.) [Indications for corticotherapy in phlebology] 
============================================================ 
SO - Phlebologie 1979 Oct-Dec;32(4):375-82 
AU - Chatard H 
MC - English Abstract 
PT - JOURNAL ARTICLE 
AB - Corticosteroid therapy has not revolutionised phlebology but it is very useful in certain cases.
The following indications are considered, with or without associated antibiotics : anaphylactic shock
after sclerosant injections, chronic lymphangitis of the lower limbs, sclero-inflammatory
hypodermatitis, eczemas, phlebitis, ulcers and angiomas. Various forms of corticosteroid therapy are
considered ; injectable, long-acting, local and oral. 

============================================================ 
10.) [A case for diagnosis: sclerosing lymphangitis of the penis]. 
============================================================ 
Ann Dermatol Venereol 1994;121(4):351-2 

[Article in French] 

Alfandari S, Delaporte E, Piette F, Bergoend H 

============================================================ 
11.) [Non-venereal sclerosing lymphangitis of the penis]. 
============================================================ 
Arch Esp Urol 1992 Sep;45(7):705-7 

[Article in Spanish] 

Murillo Mirat J, Soler Fernandez J, Torrubia Romero FJ, Caballero Gomez M, Herrera Puerto J 

Servicio de Urologia del Hospital Regional Infanta Cristina, Badajoz, Espana. 

Non-venereal sclerosing lymphangitis of the penis is a rare condition that affects the distal lymphatics
of this organ. It has been reported to be frequently associated with trauma to this area and, although
it has a minimum inflammatory component, its etiology is unknown. A serpinginous nodular lesion in
the sulcus coronarius penis may be observed by the patient. Because it is generally self-limiting,
treatment is initially conservative and surgical excision is performed only if symptomatic lesions
persist. The present study reports an additional case. The literature is reviewed and the possible
etiopathogenic mechanisms and therapeutic alternatives are discussed. 

============================================================ 
12.) [Non-venereal sclerosing lymphangitis of the penis]. 
============================================================ 
Minerva Urol Nefrol 1992 Jan-Mar;44(1):47-8 

[Article in Italian] 

Aragong F 

Publication Types: 
Letter 
============================================================ 
13.) Nonvenereal sclerosing lymphangitis of the penis. 
============================================================ 
Cutis 1991 Jun;47(6):421-2 

Gharpuray MB, Tolat SN 

Department of Dermatology, B.J. Medical College, Maharashtra, India. 
============================================================ 
14.) [A case of non-venereal sclerosing lymphangitis of the penis]. 
============================================================ 
Minerva Urol Nefrol 1991 Jan-Mar;43(1):47-8 

[Article in Italian] 

Bodo G, Ollino M, Bellandini R 

Divisione di Urologia, USSL n. 40, Ospedale Civile, Ivrea, Torino. 

The Authors describe a case of non venereal sclerosing lymphangitis of the penis. They also delineate
the differential diagnosis, the causes and the therapies of this disease. 

============================================================ 
15.) [A case of Mondor's disease of the penis]. 
============================================================ 
Hinyokika Kiyo 1988 Jul;34(7):1245-8 

[Article in Japanese] 

Doi Y, Takeyama M, Matsui T, Fujioka H 

Department of Urology, Osaka Central Hospital. 

A case of Mondor's disease of the penis in a 40-year-old man is reported. The patient complained
of a small subcutaneous induration (0.5 x 1.0 cm) with slight tenderness in the dorsal region of the
penile shaft. On examination, the linear cord was palpated running both distally and proximally from
the induration. This lesion was removed under local anesthesia, and the induration and the cord were
found to be part of the superficial dorsal vein of the penis. The venous wall was thick and the
thrombus was packed in it. Histological findings showed the proliferation of connective tissue of the
vessel wall and partially granulating thrombus in the canal. From these findings, we confirmed the
diagnosis of Mondor's disease of the penis. The etiology of this disease, especially in comparison
with non-venereal sclerosing lymphangitis of the penis (N.S.L.P.) is discussed. 

============================================================ 
16.) Non-venereal sclerosing lymphangitis of the penis associated with masturbation. 
============================================================ 
Br J Urol 1987 Feb;59(2):194-5 Related Articles, Books, LinkOut 

Sieunarine K 

============================================================ 
17.) [2 cases of sclerosing lymphangitis of the sex organs]. 
============================================================ 
Vestn Dermatol Venerol 1984 Sep;(9):64-5 

[Article in Russian] 

Vitenchuk SZ, Mitrofanova NB, Belov AS 
============================================================ 
18.) Mondor's phlebitis of the penis: a study with factor VIII related antigen. 
============================================================ 
Acta Derm Venereol 1984;64(4):337-40 Related Articles, Books, LinkOut 

Tanii T, Hamada T, Asai Y, Yorifuji T 

Four patients with so-called non-venereal sclerosing lymphangitis of the penis are reported. It was
suggested that the affected vessels were veins by positively stained factor VIII related antigen with
the unlabeled peroxidase-antiperoxidase method. If cord-like linear subcutaneous swelling observed
in the coronary sulcus or dorsal region of the penile shaft originate from the vein, it seems correct to
call this disease as Mondor's phlebitis of the penis. 

============================================================ 
19.) [Non-venereal sclerosing lymphangitis of the penis revealed as phlebitis by positive factor
VIII-related antigen]. 
============================================================ 
Nippon Hifuka Gakkai Zasshi 1983 Nov;93(12):1347-9 

[Article in Japanese] 

Tanii T, Hamada T, Asai Y, Yorifuji T 

============================================================ 
20.) Surgical management of persistent, symptomatic nonvenereal sclerosing lymphangitis of the penis. 
============================================================ 
J Urol 1982 May;127(5):987-8 
Broaddus SB, Leadbetter GW 

Nonvenereal sclerosing lymphangitis of the penis is a rare condition involving the distal lymphatics of
the penis. Its association with trauma has been shown. Although there is a minimal inflammatory
response the etiology is unknown. Clinically, the patient notices a nontender, serpiginous nodular
mass just proximal to the coronal sulcus. Most cases are self-limited and conservative management is
indicated. Surgical excision is warranted for persistently symptomatic lesions. 


============================================================ 
21.) Sclerosing lymphangitis of the penis: a lymphangiofibrosis thrombotica occlusiva. 
============================================================ 
Br J Dermatol 1981 Jun;104(6):687-95 


Marsch WC, Stuttgen G 

Three patients with so-called non-venereal sclerosing lymphangitis of the penis are presented. Light
and electron microscopy of one case revealed a lymphatic collecting vessel with a fibrin thrombus in
the process of recanalization and vessel wall fibrosis due to hyperplasia of smooth muscle cells and
fibroblasts. The term 'lymphangiofibrosis thrombotica occlusiva' is proposed. Lymph stasis is
suggested as a provoking factor for the dilatation and clinically striking firm thickening of the affected
collecting vessel. No microorganisms were recognized. Within the fibrin thrombus, sprouts of
endothelial cells showed intracellular vacuoles, probably indicating the first identifiable step in lymph
capillary lumen formation. Signs of collagen remodelling were encountered in the thickened vessel
wall. 


============================================================ 
22.) Sclerosing lymphangitis of the penis: a possible chlamydia aetiology. 
============================================================ 
Acta Derm Venereol 1981;61(5):455-6 

Kristensen JK, Scheibel J 


============================================================ 
23.) [Development of non-venereal sclerosing lymphangitis of the penis following herpetic balanitis]. 
============================================================ 
Cesk Dermatol 1979 Dec;54(6):361-3 

[Article in Slovak] 

Farkas J 
============================================================ 
============================================================ 
24.) [Case of sclerosing lymphangitis of the sex organs]. 
============================================================ 
Vestn Dermatol Venerol 1978 Nov;(11):58-61 


[Article in Russian] 

Torsuev NA, Bukharovich MN 
============================================================ 
============================================================ 
25.) [Nonveneral sclerosing lymphangitis of the penis]. 
============================================================ 
Actas Dermosifiliogr 1978 Sep-Oct;69(9-10):309-12 

[Article in Spanish] 

Moreno Izquierdo R, Merino Monge E, Guerra Tapia A, Barrio Fuertes A 

============================================================ 
============================================================ 
26.) Benign transient lymphangiectasis (sclerosing lymphangitis) of the penis. 
============================================================ 
Br J Vener Dis 1977 Dec;53(6):379-85 

Hutchins P, Dunlop EM, Rodin P 


============================================================ 
27.) [Sclerosing lymphagitis of the penis]. 
============================================================ 
Ned Tijdschr Geneeskd 1977 Oct 8;121(41):1597-8 

[Article in Dutch] 

Neering H, Starink TM 

============================================================ 
28.) Lymphocoele and localized lymphoedema of the penis. 
============================================================ 
Br J Vener Dis 1976 Dec;52(6):409-11 


McMillan A 

Six patients with lymphocoele or sclerosing lymphangitis of the penis attended the Department of
Venereology, Royal Infirmary, Edinburgh, during a 9-month period. Clinical details of these patients
are given and the aetiology of the condition is discussed. 

============================================================ 
29.) Nonvenereal sclerosing lymphangitis of the penis. 
============================================================ 
Arch Dermatol 1975 Jul;111(7):902-3 

Fiumara NJ 

Sclerosing lymphangitis of the penis with a purplish, cord-like structure, singular or multiple around
the coronal sulcus, appears 24 to 48 hours after sexual relations. There is edema of the glans penis
and coronal area, which is doughy and plastic. The condition is self-limited. 


============================================================ 
30.) Sclerosing non-venereal lymphangitis of the penis]. 
============================================================ 
Minerva Med 1973 Dec 26;64(93):4967-70 

[Article in Italian] 

Matheis H 

============================================================ 
31.) Sclerosing lymphangitis of the penis. 
============================================================ 
Br J Vener Dis 1972 Dec;48(6):545-8 Related Articles, Books, LinkOut 

Lassus A, Niemi KM, Valle SL, Kiistala U 
============================================================ 

============================================================ 
32.) Nonvenereal sclerosing lymphangitis of the penis. 
============================================================ 
Arch Dermatol 1972 May;105(5):728-9 

Greenberg RD, Perry TL 


============================================================ 
33.) Non-venereal sclerosing lymphangitis of the penis. A clinicopathologic treatise. 
============================================================ 
Acta Derm Venereol 1970;50(4):309-12 

Kandil E, al-Kashlan IM 
============================================================ 
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DATA-MEDICOS/DERMAGIC-EXPRESS No 3-(98)  31/03/2.001 DR. JOSE LAPENTA R. 
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